| Cushing's Disease
Cushing's disease is also known as hyperadrenocorticism (too much production of adrenal corticosteroid hormones). Below is an article by U.S. homeopath Cheyenne West. She has had good success in treating Cushing's disease in both dogs and horses. (Following is some further information gleaned in the course of my personal exploration of Cushing's disease, once thought to be endured by our sweet samoyed)...
Treating Cushing's Disease with Homeopathy and Other Alternative Therapies by Cheyanne West, C-Hom. All suspected Cushing's, whether in a horse or a dog, should be thoroughly investigated by a veterinarian. Thyroid problems and other skin conditions (if that is the most obvious sign) should be explored as well. (Homeopathic Formic Acid has been helpful with regards to shedding, where Cushing's symptoms prevail but the diagnosis is negative. It is known to restore a "shabby" coat to health.) Thyroid supplementation may be indicated as well. In fact, thyroid problems are often mistaken for Cushing's. Homeopathic Thyroid 30c at one drop per day for three weeks can return thyroid levels to normal - recheck levels at this point. Cushing's disease is due to an excess production of hormone from the outer part of the adrenal gland. It is usually caused by a tumor in the adrenal gland or, more commonly, by a benign tumor located on the pituitary gland (which stimulates the adrenals). The pituitary gland is the "boss", so to speak, of the endocrine system. Its main responsibility is for producing hormones which control the various other endocrine glands in the body. The growth of a tumor in either gland causes an over-production of corticosteroid hormones which, when released into the system, produce symptoms such as hair loss. (The over-use of steroid drugs can have the same effect.) Other symptoms (in both dogs and horses) can include sweating, weight loss (in spite of increased appetite), listlessness, increased intake of water, and anemia. However, the most recognizable symptom is hair loss. Homeopathic remedies have been effective when this condition is diagnosed in its early stages... Other alternatives include a variety of herbs such as kelp, nettle, rosehips, wormwood, burdock, milk thistle, garlic, clivers, clover, and apple cider vinegar. Herbs should be given in tincture and monitored closely. _____________ Cheyenne is the author of two excellent books, which are available only via her website "A Natural Path", at www.cheyannewest.com. They are useful guides for holistic veterinarians as well as pet owners... A NATURAL PATH FOR HORSES: A Guide to Homeopathy and Other Alternative Therapies - including treatments for colic, lameness, skin disorders, and behavioral problems A NATURAL PATH FOR DOGS: A Guide to Homeopathy and Other Alternative Therapies - includes an A-Z repertory of canine diseases and disorders, a section on acute and emergency treatments, discussion of breed predispositions and constitutional types _____________
Further
homeopathic suggestions: The only book in which I've been able to locate any homeopathic advice on Cushing's disease is that of British homeopath George Macleod, Dogs: homoeopathic remedies «- Clicking on this link will take you to book info at Amazon.com (Or click HERE to try Powell's used books] (1989, C.W. Daniel Company Ltd.)... "The main remedies to be considered are..." Corticotrophin (A.C.T.H.) 30c - improves adrenal function and helps reduce excess fluid which is sometimes present. Cortisone 30c - which also assists "in counteracting the affects of over production of the crude hormone." (Dr. Macleod also stresses that the over-use of steroid hormones can not only create a Cushing's symptom picture, but also prevent the effective action of homeopathic remedies. "The use of the potentised hormone along with remedies such as Nux Vomica and Thuja will help overcome this.") Thallium Acetas 30c - which "has a trophic action on the skin and hair follicles and should help restore a healthy coat." Other
important information about Cushing's disease: Though these pituitary and adrenal tumors are almost always non-malignant, they wreak havoc nonetheless... Do take them seriously! With pituitary tumors, the underlying abnormality is oversecretion of ACTH (adreno-corticotrophic hormone), which stimulates the (over)production of cortisol by the adrenocortex. With adrenal tumors, the abnormality is overstimulation of cortisol directly. Once Cushing's has well begun, most dogs are said to live only a couple of years longer, even with (mainstream) treatment. This estimation doesn't seem to be the result of much study, though. (And considering that the condition mostly attacks older critters, it may be hard to say whether the treated animal would have lived beyond that point anyway.) Horses whose Cushing's is caught early enough to avoid severe tissue damage may live for several more years (their natural lifespans being much longer than those of dogs). About steroid-induced Cushing's: even steroidal eye drops can cause Cushing's disease... Any source of long-term corticosteroid drug use (skin cream comes to mind as another easily-absorbed version) should be suspect. The only mainstream treatments involve drugs that lessen the production of (or affect of) corticosteroid hormone... But not too much! - because the right amount is essential (or hypoadrenocorticism, also known as Addison's disease, results). Constant blood and symptom monitoring are necessary thereafter. (Though, if the condition is caused by an adrenal tumor, that is often able to be removed. The more common tumor on the pituitary usually isn't treatable by surgery. Radiation is sometimes mentioned in the literature as well... I have to believe that the chemical treatment has got to be a lot safer.) For dogs, there is a simple, one-hour-between-samples blood test that can be done to determine both whether the animal has Cushing's disease, and which gland it derives from. (In my locale, the test costs about US$150.) Other types of tests are still in use as well. (In horses, Cushing's is apparently only associated with pituitary tumors.) And pituitary tumors may be found via ultrasound or CT scanning. Sometimes, though, tests may not show "Cushing's levels" even though all of the symptoms are there. Remember the possibility of hypothyroidism - but though it's a condition that's often missed, I've also read that it's often misdiagnosed when it doesn't exist. (That test is about $50, I believe.) ...In any case, this would be an excellent time to try homeopathic treatment! Then, some breeds of dogs (samoyeds, chow chows, pomeranians, toy poodles, keeshonds) are genetically predisposed to a fairly newly-recognized condition that mimics Cushing's... "adrenal hyperplasia-like syndrome". The hair falls out similarly, but the cortisone levels stay down. And it's not a life-threatening problem (though you have to be on the watch for diabetes - and ought to bolster the dog's immune system). It can be treated with Lysodren (see below), or perhaps estrogen/testosterone therapy - but since both tricky therapies can have serious side effects, one might as well leave it alone... Meaning, live with the hair loss - and protect the skin from too much sun. (Yep, it's what our once-lovely samoyed has come to... But she's still a beauty to me!) Drugs used to treat Cushing's in dogs (and a word on tumor removal) The three drugs in current use for treatment of Cushing's disease are: mitotane, A.K.A. Lysodren (the "original"); ketaconazole, A.K.A. Nizoral (the next hope); and l-deprenyl (or selegiline), A.K.A. Anipryl or Eldepryl (the newest, but disappointed, hope). I'm going to start with the latest and work backward... ANIPRYL (L-DEPRENYL): Of the three drugs in current use, l-deprenyl (or selegiline), A.K.A. Anipryl or Eldepryl (specifically for pituitary-dependent Cushing's), is the newest. It's also the easiest to track and produces lesser side effects in only a small minority of dogs. (Though it mustn't be used in conjunction with certain other drugs.) It works by balancing the brain chemicals that cause the pituitary to stimulate over-production of cortisol in the adrenals... It raises dopamine levels, which inhibits the production of ACTH. (This drug is also used for treating canine cognitive dysfunction.) Anipryl has been in use only a couple of years (I'm writing in early 2001). The following clinical information was provided to me by my very with-it veterinarian, Dr. Keith Ruble of Cascade, Idaho. He recently attended a symposium with Dr. Ellen N. Behrend of Auburn University College of Veterinary Medicine in Alabama, an expert on adrenal problems in dogs... Anipryl originally got rave reviews - but it's now become apparent that it isn't the shining light vets were hoping for... Approximately four dogs in five won't respond to this treatment at all, because it works only on tumors in a certain area (intermediate lobe) of the pituitary gland. The new clinical information is that it also stops working on a hefty majority of animals with pars intermedia tumors... Apparently when the tumor grows into the areas that it doesn't have an effect on. At that point, it's back to the original drug, Lysodren. [A couple of points of clarification: The blood tests can not determine which lobe of the pituitary the dog's tumor is in - only that it's in the pituitary and not the adrenals. And researchers have not been able to verify that any drug treatment will affect tumors in the anterior lobe of the pituitary... Which must account for a significant portion of the animals who don't respond to Anipryl or Ketoconazole.] Most vets now feel that with the greater monthly expense for the drug, and the probable need (and expense) for re-testing when it stops working, they're serving their clients better by recommending Lysodren initially and going to Anipryl only if Lysodren proves problematical. Interestingly, l-deprenyl is the only drug the F.D.A. approves for Cushing's treatment in dogs. (Yeah - always take that with a grain of salt... if not a tablespoonful.) NIZORAL (KETACONAZOLE): Nizoral is also used mostly for pituitary tumors, though Dr. Behrend reports that it can work on adrenal tumors as well. It somehow blocks the synthesis of cortisol in the adrenals. ...But that means that steroid levels are kept high - which ultimately isn't great for the animal. Nizoral is tricky to adjust properly, is I expensive, and can't be absorbed well enough by at least one in five dogs. It has the reputation of not being seriously toxic - but acute hepatitis or gastritis must be watched for initially (!)... and nausea is a rather common reaction. One good thing is that it doesn't cause irreparable damage if the levels aren't maintained properly. It doesn't seem to have the fall-off of effectiveness that Anipryl does, so it can presumably be used successfully long-term. But because it costs so much, many veterinarians aren't familiar with this drug at all - most people just can't afford it. (My vet said that he'd have to refer people to the nearest university with a veterinary program if it came down to Nizoral as a last hope.) It's usually reserved for animals that don't respond to either of the other drug possibilities. LYSODREN (MITOTANE): Lysodren is the one that any vet will be familiar with. It kills off the outer layer of the adrenal glands to curb the production of cortisol... i.e., it is a chemotherapy drug. It causes the most side effects and is the most dangerous to use incorrectly. ...Accurate monitoring is critical, because over-erosion of the adrenocortex can be permanent. It's typical for the pet owner to be in daily contact with the veterinarian for a couple of weeks or more after the treatment is begun. But vets are well-versed in its use (and usually the adrenocortex grows back in about a month if a bit too much of the drug has been given - which is probably very rare, and I suspect more likely to happen when owners don't keep up with the monitoring schedule). Lysodren is by far the cheapest drug of the three... and, despite hopes to the contrary, it's also most often the best choice. It doesn't have to be given daily; and after the initial "setup" period, monitoring need only be done 2-3 times a year. TUMOR REMOVAL: Since it acts directly on the production of cortisol, Lysodren can be used for both pituitary and adrenal tumor Cushing's. However, the recommended treatment for an adrenal tumor is to have it removed, if possible (i.e., if the other adrenal tumor is found to be sound). This is because Lysodren, which works well on healthy adrenal tissue, is apparently not as effective on tumor tissue... So as the tumor grows (remember, none of these drugs affect the tumors themselves), the drug doesn't work as well. ...Not only isn't there an alternate drug to use then - it's possible that the other adrenal gland could have developed a tumor by then, so that tumor removal later on would also be out. (Besides, the older the dog is, the more danger there is in any surgical procedure.) ...So at diagnosis, you'd be advised to get an ultrasound to make sure the second adrenal gland is healthy. And if it is, to spend the money (my vet says several hundred dollars) on the surgery/etc. (thereby saving all the monthly drug money everafter). Removal of pituitary tumors? ...Apparently it's sometimes possible - Dr. Ruble knows of one family that mortgaged their home to have this $20,000 operation performed on their beloved 13-year-old pet. I can sympathize entirely - but most people wouldn't be able to come up with such a huge sum for any purpose. Drug treatments for horses Bromocriptine mesylate (A.K.A. Parlodel) mimics dopamine, which results in a decrease in cortisol. It has numerous side effects, though, and is poorly absorbed by many animals. Cyproheptadine is a serotonin blocker that's used much more successfully and is not terribly expensive. It works on about two-thirds of horses. Pergolide mesylate (A.K.A. Permax) is another dopamine mimic that is much easier on the animal than Parlodel. It's a little more expensive than cyproheptadine and apparently is often a second choice if cyproheptadine doesn't "take" with a certain horse.
Though the disease, if left untreated, usually doesn't progress very quickly in either animal, it can do so. We who wish to use alternative treatment methods may be caught in a bind - there likely isn't that much time in which to try out other options. ...Because if left untreated too long, Cushing's can lead to very serious health problems such as a weakened heart, high blood pressure, blood clots, and diabetes that can't be rectified with insulin. (Make sure your pet is "concentrating its urine" - i.e., its urine is yellow, not so dilute as to be very pale... a sign of diabetes.) Loss of muscle tone in the rear legs is also a serious disability that may not be able to be remedied once muscles have degenerated too far. Pancreatitis also can accompany the condition. And in horses, there is a higher incidence of bone fractures and foundering. Other symptoms not mentioned above can be: increase in respiratory rate, a distended abdomen, thinning of the skin, darkening of the skin, skin infections or rashes, calcified lumps under the skin which can eventually lead to scaling and itchiness, drying out of the hair, chronic urinary tract infections, increased sleeping time, seizures or other nervous system changes, and, in males dogs, shrinking of the testicles. The hair loss, by the way, tends to be evenly spaced on both sides of the body (commonly beginning in dogs on the back legs). One more symptom, noticeable to the vet, is enlargement of the liver - hence the great liver- and blood-cleansing herbs Cheyenne mentioned. Horses also may develop a thick, long, and sometimes curly coat that won't shed; they're also susceptible to worm overload. Dr. Ruble strongly suspected that my Iris had Cushing's... When he encouraged me to get the blood test done soon, I told him I was thinking about it and researching it... But that it went against my grain to resort to chemotherapeutic drugs that, in effect, damage the immune system. He said, "I know... but Cushing's disease (if that's what she has) is damaging her immune system." That brought me up sharply! Because the drugs do usually stop, and reverse, the condition. The hair usually grows back within several months. The other symptoms, if tissue damage hasn't been severe, also lessen considerably or may disappear entirely. Left to itself, the condition will eventually kill an animal. No, I certainly don't always do only alternative medicine. ...Only when it makes the best sense. ...Which is not to say that it still might not be appropriate to treat the animal with natural methods. The drugs don't correct the underlying problem, since the drug choices don't shrink the tumors or keep them from growing. With horses, for instance, the pituitary tumor will eventually cause blindness and impact the brain, etc. ...Looking ahead to possible problems down the road may help by strengthening vulnerabilities. (By the way, I give Iris cayenne, co-enzyme Q10, garlic, vitamin E, and fish oil daily... She isn't going to develop heart problems if I can help it! I give her multiple vits/mins, green food, and digestive enzymes too. In re-reading this, it might be good to add some liver herbs as well. ...I think it behooves anyone to bolster the weak points at as early a stage as possible.)
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